People with Spina Bifida in Texas can get federal disability benefits like SSI and SSDI, plus state Medicaid waivers and ABLE accounts. This guide explains eligibility, how to apply, and key resources.
To get Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) in Texas, your Spina Bifida must meet the Social Security Administration’s (SSA) definition of disability. This means:
The SSA uses a 5-step process to decide if you qualify. First, they check if you are working above the Substantial Gainful Activity (SGA) limit. In 2025, SGA is $1,620/month for non-blind people and $2,700/month for blind people. Next, they look at the severity of your condition, whether it matches a listed impairment in the SSA’s Blue Book, your Residual Functional Capacity (RFC), and your ability to do other work. If you cannot do past work or adjust to other jobs, you may be eligible for benefits[1][2][5][6].
Texas does not have its own state disability benefits program. The only disability benefits available are federal programs like SSI and SSDI. However, Texas offers Medicaid waivers for people with disabilities, including Spina Bifida, to help pay for home and community-based services. These waivers can cover things like personal care, therapy, and assistive devices. To qualify for Medicaid waivers, you must meet both medical and financial criteria set by the Texas Health and Human Services Commission. Spina Bifida is considered a qualifying condition for these programs if it causes significant functional limitations[1][3][4].
Check Eligibility: Review SSA’s Blue Book for Spina Bifida (Listing 111.07 for neurological disorders). Make sure your condition is medically documented and expected to last at least 12 months[1][4][6].
Gather Documents: Collect medical records, doctor’s reports, lab results, and a list of treatments. For SSDI, also get work history and W-2s. For SSI, gather income and resource info[1][3][5].
Apply: Apply online at SSA.gov, call 1-800-772-1213, or visit a local Social Security office. For Medicaid waivers, apply at YourTexasBenefits.com or your local HHSC office[1][3][5].
Wait for Decision: The SSA or Texas HHSC will review your application. Most claims are denied at first, so be ready to appeal if needed[3].
Appeal if Denied: If your claim is denied, you have 60 days to appeal. You can request a reconsideration, a hearing, or review by an administrative law judge[3].
Follow Up: Keep records of all communications and send updates if your condition changes[3].
The main federal programs for Spina Bifida in Texas are:
Texas offers several programs for people with Spina Bifida:
ABLE accounts let Texans with disabilities save money for disability-related expenses without losing SSI or Medicaid benefits. You can save up to $18,000 per year in 2025. Funds can be used for things like housing, education, and personal support. Learn more about Texas ABLE accounts and how to open one[7].
For SSI in Texas in 2025:
For SSDI, there is no income limit, but you cannot earn more than $1,620/month (non-blind) or $2,700/month (blind) from work[2][3][4].
If your income or resources change, you must report it to the SSA or Texas HHSC. Not reporting changes can lead to overpayments and penalties. Use the SSA’s online portal or call your local office to report changes. Learn more about avoiding overpayments and reporting changes[3].
Many Texans with Spina Bifida get help from disability advocates or lawyers when applying for benefits. You can also call the Social Security Administration at 1-800-772-1213 for free help.
Yes, Spina Bifida can qualify for SSI and SSDI if it meets the SSA’s disability criteria. This means it must be medically documented, last at least 12 months, and significantly limit your ability to work or do daily activities[1][4][6].
In 2025, the Substantial Gainful Activity (SGA) limit is $1,620/month for non-blind people and $2,700/month for blind people. Earning above this limit may affect your eligibility for disability benefits[2][4][6].
To apply for Medicaid waivers in Texas, visit YourTexasBenefits.com or your local HHSC office. You’ll need to provide medical and financial information to show you meet the program’s criteria[1][3].
Yes, children with Spina Bifida can get SSI if their condition causes marked and severe functional limitations. The SSA also considers the child’s and family’s income and resources when deciding eligibility[4][6].
The maximum SSDI benefit in Texas in 2025 is $4,018 per month. Most people get less, based on their work history and earnings[7].
ABLE accounts let Texans with disabilities save money for disability-related expenses without losing SSI or Medicaid benefits. You can save up to $18,000 per year, and funds can be used for things like housing, education, and personal support[7].
This guide is for informational purposes only and is not legal or financial advice. Always consult with a qualified professional for personalized guidance.
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If your disability claim is denied, you have 60 days to appeal. You can request a reconsideration, a hearing, or review by an administrative law judge. Most claims are denied at first, so be ready to appeal[3].
Yes, you can work while getting disability benefits, but there are limits. For SSI, you can earn up to $1,620/month (non-blind) or $2,700/month (blind) without losing benefits. SSDI has a trial work period where you can earn more for a limited time[2][6].
The resource limit for SSI in Texas is $2,000 for individuals and $3,000 for couples. Resources include cash, bank accounts, and property, but not your home or one car[2][3].
You must report changes in income, resources, or living situation to the SSA or Texas HHSC. Use the SSA’s online portal or call your local office to report changes and avoid overpayments[3].
